CLINICAL MANAGEMENT OF DEEP VEIN THROMBOSIS OF THE INFERIOR VENA CAVA SYSTEM IN PREGNANT WOMEN

Objectives. To analyze the treatment of patients with deep vein thrombosis in the inferior vena cava system during pregnancy. Materials and methods. The study is based on the survey results of 23 pregnant women with deep vein thrombosis (DVT) (the study group). The average age of patients was 27,4±5,8 years (M±g). All women were divided into two subgroups depending on the gestation terms: in 9 pregnant patients thrombosis developed in the 2nd trimester, in 14 - in the 3rd trimester. Plasma hemostasis investigations, ultrasound triplex scanning of the lower limbs, fetal ultrasound study with Doppler utero-placental blood flow were performed in all patients. Results. In the 3rd trimester one woman was diagnosed with the missed abortion. The operation of a small cesarean section was performed in this patient. In the other 8 cases of a progressing pregnancy one administered the conservative treatment with the use of elastic compression, direct anticoagulants and drugs improving microcirculation. Clinical management of 14 patients with DVT developed in the 3rd trimester depended on the nature of the thrombotic masses. All patients were diagnosed the occlusive nature of the clot, the floating thrombosis was not detected in any case and the patients were treated conservatively. The delivery by means of cesarean section was routinely carried out in all women in the period of 37-38 weeks. One patient the delivery was complicated by the pulmonary embolism of the peripheral branches. Results. The obtained results have demonstrated the application expediency of the worked out clinical management in treating pregnant women with deep vein thrombosis in the inferior vena cava system